Gersh B J, Holmes D R
Division of Cardiovascular Diseases and Internal Medicine, Mayo Clinic, Rochester, Minnesota 55905.
Int J Cardiol. 1993 Jul 1;40(2):81-8. doi: 10.1016/0167-5273(93)90268-l.
The treatment modalities for patients with chronic stable angina have expanded since the introduction of percutaneous revascularization procedures such as percutaneous transluminal coronary angioplasty. In selected patients, these percutaneous procedures provide an excellent alternative to surgical revascularization; in other patients, percutaneous transluminal coronary angioplasty is an excellent alternative to medical therapy. Selection of the optimal therapy depends on the specific coronary anatomy, left ventricular function, clinical setting, and the need for complete revascularization. Also, the availability of bailout devices, such as stents for the dilatation procedure, needs to be considered in higher risk patients or higher risk lesions. Currently, randomized trials that are being completed will allow comparison of surgical versus angioplasty approaches and will improve our ability to tailor therapy for specific subsets of patients.
自从诸如经皮腔内冠状动脉成形术等经皮血运重建手术引入以来，慢性稳定型心绞痛患者的治疗方式有所增加。对于部分患者而言，这些经皮手术为外科血运重建提供了绝佳替代方案；对于其他患者，经皮腔内冠状动脉成形术是药物治疗的良好替代方法。最佳治疗方案的选择取决于特定的冠状动脉解剖结构、左心室功能、临床情况以及完全血运重建的需求。此外，对于高风险患者或高风险病变，需要考虑是否具备补救设备，如用于扩张手术的支架。目前，正在完成的随机试验将有助于比较手术与血管成形术方法，并提高我们针对特定患者亚组量身定制治疗方案的能力。
